YOUR HEALTH - The Citizen

Common diseases to be aware of during rainy season

Monday May 20 2019


By John Namkwahe

Going out and enjoying the showers of the season, gorging on great street food, and playing in puddles of water is how many of us wish to be associated with the rains. But all of these come with the risk of exposing ourselves to various germs and viruses, which lead to spending the rest of the season in bed due to sickness.

Rainy season illness in babies also begins to ramp up since their bodies are suddenly exposed to a huge fluctuation in the atmosphere and a considerably larger amount of microorganisms that the body has to fight against.

Ms Bernadetha Lugwisha, 32, from Mabibo, Dar es Salaam narrates to Your Health that her 4-year-old daughter Chanice fell sick at midnight on Wednesday and her body temperature increased to 39.1 degrees celsius, a sign of fever.

Most doctors agree that a normal body temperature for a healthy child is between 97 and 100.4 degrees fahrenheit (36 to 38 degrees celsius).

A child is considered to have fever if his or her body temperature is higher than 38 degrees celsius. High fever usually means more than 39 degrees celsius.

“I gave her paracetamol and the body temperature dropped to 38.9 degrees celsius. But after a few hours later at around 4 am, her body temperature increased up to 39.3 degrees celsius. I had to wait until 7 am in the morning and I took her to the Regency Medical Centre for treatment,” says Bernadetha.

Upon arrival at the hospital, they were received at the Emergency Unit and later instructed to see a paediatrician for further medical examination.

“Her body temperature was still higher, I was very worried. My husband had travelled. I was accompanied to the hospital by a house girl,” she says.

The hospital’s results showed that Chanice had dengue fever and therefore the doctor recommended that she had to be admitted at the hospital for a prolonged medication to treat the fever.

“The hospital charged me Sh60,000 for the medical examination. Then after she was diagnosed with dengue fever, the doctor instructed that she has to take paracetamol to control fever and drink a lot of water at the same time. I thank God, her condition keeps improving, she will be discharged any time soon,” says Bernadetha.

Why paracetamol?

Speaking to Your Health over the telephone last week, Dr Rahim Damji , a Paediatrician at Regency Medical Centre explained that the paracetamol relieves pain, further noting that the medicine also reduces raised body temperature (fever).

He further elaborated that patients can take a dose of paracetamol every 4-6 hours if needed, but cautioned that patients should not take more than four doses in any 24-hour period.

“Drugs like Diclofenac, Ibuprofen and Aspirin are all under the group of NSAIDs (Non-steroidal anti-inflammatory drugs). They all carry antiplatelet benefit hence thinning the blood. During Dengue illness, most of the time the platelet count is low hence the chances of bleeding from the skin and mucous membranes are increased. Hence, taking NSAIDs during that time is prohibited,” Dr Damji further explained.

He added, “Again, dengue fever causes fever and dehydration, hence water is recommended to lower the body temperature and reduce chances of dehydration.”

Causes of dengue

Dengue fever is caused by any one of four types of dengue viruses spread by mosquitoes that thrive in and near human lodgings. When a mosquito bites a person infected with a dengue virus, the virus enters the mosquito. When the infected mosquito then bites another person, the virus enters that person’s bloodstream.


Dr Damji pointed out some key symptoms of the disease including extreme pain in the joints and muscles, swelling of the lymph nodes, weakness, headaches, fever, that can even lead to haemorrhagic bleeding which can be fatal.


In order to curb the spreading of dengue fever, Dr Damji advised people to clean all water containers once a week and scrub the sides well to remove eggs of mosquitoes sticking to the sides.

He further advised people to clean gutters of leaves and debris so that rainwater will not collect as breeding places of mosquitoes.

“I urge people to puncture or cut old tires used as roof support to avoid the accumulation of water. Again, they should collect and dispose of all unusable tin cans, jars, bottles, and other items that can collect and hold water,” advised Dr Damji.

Global burden of dengue

The incidence of dengue has grown dramatically around the world in recent decades. A vast majority of cases are asymptomatic and hence the actual numbers of dengue cases are underreported and many cases are misclassified.

One estimate indicates 390 million dengue infections per year (95 per cent credible interval 284–528 million), of which 96 million (67–136 million) manifest clinically (with any severity of disease).

Another study, of the prevalence of dengue, estimates that 3.9 billion people, in 128 countries, are at risk of infection with dengue viruses.

Member States in three World Health Organisation (WHO) regions regularly report the annual number of cases. The number of cases reported increased from 2.2 million in 2010 to over 3.34 million in 2016. Although the full global burden of the disease is uncertain, the initiation of activities to record all dengue cases partly explains the sharp increase in the number of cases reported in recent years.

In Tanzania, cases of patients being diagnosed with dengue fever in Dar es Salaam have increased by 50.8 per cent in a week, the Chief Medical Officer, Prof Muhammad Kambi revealed during a press conference last week.

He further revealed that the number increased from 1,200 to 1,809 patients recorded in Dar es Salaam alone, citing that so far at least 1,901 patients have been diagnosed with the fever countrywide.

How to prevent other common rainy season diseases

Apart from diseases spread by mosquitoes such as dengue and malaria, the rainy season may bring with it other diseases that endanger the health of children, said Dr Mariam Noorani, Paediatrician and Head of Paediatric Department at Aga Khan Hospital in Dar es Salaam when she spoke to Your Health last week.

She added: “Some of these include water-borne diseases such as diarrheal diseases and hepatitis A, which can be spread by drinking contaminated water. Other diseases include skin conditions especially fungal skin infections which occur if children play in dirty water and infection of open wounds which get contaminated with water.”

Referring to the tips to prevent children from developing the diseases, Dr Noorani advised parents to discourage their children from playing in areas flooded by rainwater and make sure their children always wash hands after contact with rain and flood water.

Again she further advised people to remove collected rain water around the house and make sure children sleep in insecticide-treated bed nets.

“Use of mosquito repellants and long sleeves and trousers to cover children’s arms and legs is also useful. Children should wear closed shoes if they have to walk through puddles of water. If a child has a wound, wash it with clean water and keep it dry,” advised Dr Noorani.

Following the increase of dengue cases in the country, the government last week assured Tanzanians that it embarked on conducting deliberate preventive and treatment measures including distributing medical supplies for testing dengue free of charge with a particular focus on curbing the burden.

“We have ordered 3,000 test kits, of which 200 have already landed in the country, ready for distribution to various hospitals in Dar es Salaam,” revealed Prof Kambi.


How cycling changed my life

Monday May 20 2019


By Tasneem Hassanali

As a child, Heri Tungaraza cycled as part of play just like his age-mates at that time. His dad bought him his first bicycle. “It was a foldable one and unlike other bicycles at that time, the brakes of this one were initiated but with a reverse pedal. It was a bicycle from Holland,” 39-year-old Oncologist, Dr Tungaraza recalls.

In his teenage years, he rode occasionally to medical school when he bought himself a mountain bike but he didn’t ride for long.

He resumed cycling when he was in China doing his Masters. “When I was in China, that time the motivation was as part of a workout. And I have not stopped since then,” Dr Tungaraza tells Your Health.

Dr Tungaraza rarely uses cycling as a means of commute because of the many challenges.

“One of them is the lack of changing and shower rooms at work. The other is the bad traffic during peak hours. Since we don’t have cycling lanes in most parts of the city, it becomes dangerous and our motorists don’t respect us as yet,” he says.

However this past week, Dr Tungaraza took his bicycle with him to Morogoro and while there he did use it to go to work and run a few errands and go for dinner 4kms away. “So I mainly cycle for workouts in the morning hours when the traffic is at the minimum,” he says.

His childhood pastime of cycling has now become a habit

Dr Tungaraza mostly cycles with a bunch of cycling enthusiasts. “I have several cycling groups to sweat with over the weekend. I cycle at least once per week and a maximum of three times per week. During the weekend I get the maximum time,” he tells.

Being in the health field himself, Dr Tungaraza explains that the advantages of cycling are many.

The list is long but it does help one stay in shape, keep fit, improve cardiovascular system, lose weight when combined with a proper diet, improve flexibility and muscle strength, increase bone strength, reduce stress and also cycling has been associated with prevention of chronic diseases like heart diseases and cancer.

He adds, “Of course cycling to work or errands means less pollution and cheaper too.”

Which bicycle to opt for?

On suggesting which bicycle to go for, Dr Tungaraza says just like buying a car or anything for that matter one needs to look at his or her needs. There are different types of bicycles but there are two major groups i.e. Mountain bikes and road bikes.

The mountain bikes are those with big tyres and are meant for off-road and any other road. For someone buying a bike for the first time in Tanzania should opt for this.

So they are able to ride almost anywhere at a speed that is safe enough.

The road bikes are for those with need for speed or adrenaline junks. “The things to look for are size (size 26 is preferred), brands (there are many) and of course affordability. Currently in the market we get both new and second hand bikes mostly from Europe and Japan. I have both types to satisfy my thirst for variety,” he explains.

Mental well-being

Cycling has improved Dr Tungaraza’s mental wellbeing, as he tells. “Possibly unknowingly, cycling allows me to feel free and wonder around mentally and physically. With the blood gushing to my brain, I am usually at peace and I feel good while on the saddle. Cycling has also enabled me go places that I had never been before here within Dar and that has helped me load my brain with beautiful moments and respect nature. Good nutrition for the brain indeed,” Dr Tungaraza explains.


The roads are not very safe and friendly for cyclists in Dar es Salaam. Most main roads don’t have cycling lanes. “The Morogoro road was well constructed, it does have bike lanes and that’s the real meaning of inclusiveness. In fact, if we want people to fight off diseases such as the non-communicable diseases, we should have more cycling lanes on our roads to encourage people to cycle more and hence be healthy,” Dr Tungaraza advises.

Currently morning hours remain the best times to ride and a few areas like University of Dar es Salaam and Masaki are ideal and safer to ride, Dr Tungaraza says. For those who own a mountain bike, there are a lot of trails or off-road routes.

Cycle away from the big C

Cycling does cut cancer risks Evidence has linked more specifically colon and breast cancer to cycling. If one cycles, the risks of getting these cancer goes down.

“With cycling your anticipated weight loss will also add value to reducing risk of getting other obesity related cancers,” he explains.


Useful tips to manage asthma among school-going children

Monday May 13 2019


By Gean Cabral

It was way back in the late 1990’s when this little girl of two years suffered with recurrent, productive and wheezy coughs accompanied with fevers every single month. Along with all the cough and cold medications, she was also on antibiotics. She would constantly miss school (play school) for being so sick.

It was only until her mother had the opportunity a year later to have her child properly diagnosed, did she realise that she was actually suffering from asthma. The girl suffered so severely, gasping for breath, that she was constantly rushed to the hospital for nebulisation [a drug delivery device used to administer medication in the form of a mist inhaled into the lungs].

The mother having become sick with worry with the notion that this disease is life threatening, drove her to learn how to beat the asthma symptoms by not only constantly watching her child and realising what is aggravating her attacks but also by gaining knowledge about its control and management.

The child would wake up in the middle of the night coughing up sputum and vomiting. This, was due to the allergic reaction to dust mites (invisible to the naked eye), and although the bed room had no dust the allergen was present. To combat this, the whole room with furniture was cleaned with detol diluted in water. That did the trick said the mother; no more night duties!

Environmental triggers were avoided, and a watch out for what the child ate was kept in check, peanuts, especially were detrimental to the child’s health, causing raspy wheezing and coughing, gasping, and breathlessness.

At the same time the child benefited from vitamin C rich soups and foods, and teas made with honey and sometimes with turmeric and a spot of ginger.

The mother having stumbled across a good paediatrician learnt about the different inhalers, and when to take them.

With all the care, it only took the child another couple of years before she did not ever require to use the nebulizer, and only very seldom uses her inhaler. The child was trained on how to cope with her asthma, to know of her allergens, weather changes that can trigger an attack, and to know her warning signs so she can take her appropriate medication in a timely manner.

So, moms, dads, guardians, teachers, children with asthma having proper medical diagnosis and management can greatly reduce the number of attacks and enjoy life to the fullest! Asthma is not contagious, and it is not a disease to be afraid of, or to run away from. Although asthma cannot be cured, it can be managed and controlled.

Asthma is chronic disease of the lungs caused by swelling and irritation in the lining of the airways. Tightness of the airway muscles along with excess mucus makes breathing difficult.

Asthma is a leading cause of school absenteeism, but by encouraging guardians and school personnel to recognise asthma as a chronic disease requiring ongoing care and management, school attendance can be improved and ultimately asthma will be controlled.

When children’s asthma is managed effectively, they will have minimal or no asthma symptoms and so they can safely participate in all their hobbies and school activities.

Effective management of asthma also prevents symptoms of acute episodes and minimises the amount of medications, and reduces long term lung damage.

A person with asthma may need two types of medications, one a preventer and the other as a bronchodilator.

Asthma treatment does not just end in the hospital, but it is an ongoing process of managing the asthma at home too, to minimise your attacks, know of your ‘warning signs’, avoid environmental triggers and allergens, and know of your action / prevention plan.

As the saying goes – ‘that which cannot be measured, cannot be changed’, you will only have difficulty getting control of your asthma, if you do not monitor your asthma symptoms well.

The author writes from an NGO Sanitas Medical Foundation currently raising asthma awareness.


Consider this when breaking your fast

Monday May 13 2019


By Jamilah Khaji

During the holy month of Ramadan, a healthy adult Muslim fast from dawn until dusk. The fast includes abstaining from drinking, eating, immoral acts and anger. Doing other acts of worship such as prayers, reading the Quran and charity are encouraged. Muslims also believe that Quran was revealed in the holy month of Ramadan.

Fasting is one of the pillars of Islma; there is also a verse in the Quran that prescribe fasting for all Muslims who are mature and healthy enough to fast all day. This month is believed to bring people together and become compassionate to one another; fasting is also seen as a way to be patient and break bad habits.

During this month, those who fast have two main meals; they wake up at dawn to eat a meal called suhoor and break the fast in the evening with the meal referred as Iftar.

Every year during Ramadan, healthcare professionals across the country see hundreds of residents suffering from a condition that only surfaces that month, stomach cramps and bloated bellies.

After more than 14 hours of fasting, it can be tempting to break your fast with enthusiasm, but you could be spoiling your enjoyment and harming your health.

“It is usually because they over eat,” says Pazi Mwinyimvua, a Nutritionist at College of Agricultural Sciences and Fisheries Technology (CoAF), University of Dar es salaam.

Every year, doctors repeat the same advice to those fasting: Break you fast by eating in moderation and gradually.

And every year, the numbers are steady across the hospital network.

Mr Mwinyimvua says when breaking your fast, you are advised to eat healthy by including all groups such as vitamins, carbohydrates, proteins, fats and minerals.“And all that has to be eaten in the right amount,” he says.

What to eat

Mr Mwinyimvua says, “Think of your stomach as a car engine that has been switched off for a long time. When you restart it, you need to give it time to warm up before speeding off. The same applies to the digestive system. It has been dormant for a long period of time and you can’t suddenly overload it with food.”

Nutritionists advice to start breaking fast with a few dates and some soup or porridge followed by a short break, perhaps to pray, before returning to eat more.

It is always advisable to have small, light, frequent and nutritious meals during Iftar, food with natural sugar such as sweet potatoes, pumpkins, cassava are more advisable for Iftar because they are light food and easy to be digested” says Mr Mwinyimvua. “And avoid fatty foods, beverages, juices and syrups with high concentrated sugar that are always served during Ramadan,” he added.

Many vegetables and fruits are high in water content. It is advisable to have them during Iftar to compensate for the water loss during the day.


Suhoor is in many ways the most important meal during Ramadan and prevents nausea and headaches while fasting during the day.

The nutritionist advices to eat heavy food such as foods made from grain, wheat flour, milk and lots of vegetables which means when fasters rise for work, they will have plenty of energy, at least for the start of the day, and not feel queasy from hunger.

“It is best to avoid any salty, processed and canned foods, avoid eating food with too much sugar, oil and salt,” Mr Mwinyimvua says.

For those who suffer from caffeine withdrawals he says, “Decrease the number of caffeine intake a week or two before Ramadan, also it is not advisable to drink tea or coffee because it causes to pee many times, which may result to dehydration”.

Skip the gym

Health experts advise people not to use fasting as a means to diet and reduce their weight by additional workouts. The body is already fatigued and this is not the purpose of fasting.

Sleep is also of particular importance if an individual wants to keep their energy levels up while fasting.

This can be challenging when Ramadan tents and entertainment run into the early hours of the morning.

“Managing our sleeping hours is the most difficult area but is also very important. If you don’t get enough sleep and in addition to fasting, then you will be unable to focus at work,” Mr Mwinyimvua says.

Mr Mwinyimvua recommends sleeping after Iftar until about 11pm or midnight, and then after suhoor.

After suhoor they can sleep again for a few hours before heading to work so that in total you would have slept around six to seven hours.”


25 health advantages of doing light exercises

Monday May 13 2019

 A man at the gym doing strength

 A man at the gym doing strength exercise.PHOTO|PEXELS 

By Tasneem Hassanali

Many people worry about their weight at some point during their life. Maybe you have struggled with your weight going up and down for years, or perhaps it increased following a difficult time in your life.

If you are overweight or obese, you are not alone – according to the World Health Organisation, around 1.9 billion adults worldwide are overweight or obese. But being overweight or obese can increase your risk of developing type 2 diabetes, heart disease and high blood pressure.

Not only that, it is also linked to developing cancer and can cause joint problems and back pain. It can even be responsible for causing trouble sleeping and low self-esteem.

The World Health Organisation (WHO) advises that in order to become healthy, one is supposed to do light exercises for at least 150 minutes per week, meaning spending 30 minutes in five days of the week.

However, we need to ask ourselves, how many people who do exercises know about health advantages?

For 27-year-old Mpoki Thomson, being active is an important part of losing weight and keeping it off. He says the more active he is, the more calories he burns up, which makes it easier to lose weight.

Due to poor eating habits, Mr Thomson started gaining a lot of weight. So in 2012, he decided to start exercising in order to maintain a balance between his choices of food and eating preferences.

“In the long run I had to watch my diet as well. I came to learn that you can’t have your cake and eat it too. You can’t exercise and continue on a bad diet, it is counterproductive,” Mr Thomson tells Your Health.

He started with light weights just to adjust his body to the new changes, but soon after, Mr Thomson advanced to heavy weights to build strength and because he had a lot of fats that needed to be dealt with. “Endurance was key in order for my body to adapt,” he says.

Mr Thomson lost about 15 kilogrammes and since then he has built a discipline in terms of his schedule to maintain his required weight. He says, “I exercise 5 days a week. I mostly rest on weekends. Or sometimes I workout from Monday to Wednesday, rest on Thursday, then workout Friday/Saturday, rest on Sunday again.”

Mr Thomson reveals that ever since he embarked on the discipline of working out, most aspect of his lifestyle have changed for the better, both physically and mentally.

“Physically, my body started changing fast. For a guy who was on the road to being fat, when I started exercising and lifting heavy weights, within a short period of time my body started transforming. Mentally, my mindset became more conscious on my choice of lifestyle, I became more cautious on my eating habits and other indulgences that might be considered unhealthy,” he says.

But with exercising, Mr Thomson had to deal with stretch marks. “Your skin stretches a lot trying to accommodate the gained muscle, there is a risk of developing stretch marks, that’s one of the issues I’ve had to deal with over the years. So you can find a lot of bulky guys with stretch marks on their upper chests and arms,” Mr Thomson reveals.

Get moving

You can make it easier to achieve your daily exercise target by building activity into your everyday life and not always seeing it as something extra to fit in, which we term it as light exercises. Walking slowly, cooking, vacuuming, gardening, dusting and golfing using a cart to travel between tees are all types of light exercise.

Walking more is a good way of doing this and also does not cost anything. Try walking to the shops instead of driving or taking the stairs instead of the lift.

It is important that you reduce the amount of time you spend sitting still. Watching TV, driving, playing on the computer or sitting at a desk burn up very few calories. Combine aerobic training that burns fat, such as running, with resistance exercise such as weight training that builds muscle.

According to the World Health Organization, men with a waist measurement of 102 cm (40 inches) or more, and women with a waist measurement of 88 cm (34.5 inches) or more, have the greatest risk to their health.

These guidelines may vary from country to country.

Dr Shita Samwel, a general physician based in Dar es Salaam tells Your Health on the 25 health advantages of doing light exercises when you make it part of your daily life.

1. Protects you against non-communicable diseases

Doing regular exercises helps you reduce the risk of being attacked by non-communicable diseases including heart-related illnesses like stroke, cancer and diabetes. Doing exercises also helps you to have healthy heart and well workable blood systems.

2. Controls obese and excessive body weight

Obesity is a risky sign of making you get different types of non-communicable diseases, but by doing exercises your body parts will get activated, accumulated fat in your body will also get burned and finally controlling your excess body weight.

3. Lowers high blood pressure

Doing exercise helps make your heart and blood vessels become healthy as it also contributes to bringing down your high blood pressure, which is a silent killer.

4. Strengthens respiratory system

Exercises such as walking, jogging and swimming helps make your body muscles work efficiently by increasing oxygen flow in your lungs that directly removes carbondioxide from the body.

5. Improves food system

Physical exercises helps you build an appetite. It helps food to be digested, absorbed and easily removed from the body hence avoid the problems of stomach gas and constipation.

6. Reduces the risk of succumbing to cancer

Studies show that those who do physical exercises have the little danger of suffering from breast, rectum and lung cancers compared to those who do not.

7. Controls bad cholesterol

Cholesterol is that fat stored within the blood vessels. So, physical exercises reduce a quantity of bad cholesterol and instead increase a volume of good cholesterol that has an advantage for the body.

Bad cholesterol normally destroys the blood vessels including the heart. So, controlling it reduces the risk of getting a heart attack and stroke.

8. Firm protection against illnesses

The more you do an exercise the more you avoid the danger of suffering from different diseases. This is because exercising makes you have a strong protection against contracting viruses.

9. Strong muscles

Physical exercises strengthens your muscles and makes you become much stronger and enables you to withstand difficult circumstances.

10. Lightens body joints

They help lighten body joints to enable you to quickly and efficiently do different physical jobs without easily picking injuries.

11. Strong bones

Exercises help you have strong and well-built bones that enable you to have a reduced risk of having a bone disease, which is medically known as osteoporosis. It is a disease that makes bones crumble.

13. Calmness and sound sleep

Exercises contribute to making you have bodily calmness and sound sleep, which has an advantage for the body including correcting different bodily malfunctions and building a strong immunity.

14. Improves mental health

A chemical known as endorphin, which is produced during a physical exercises, causes the body to have a good feeling of happiness.

Likewise, exercising helps you dispel a negative feeling including fear and depression. It also makes you feel a new person, who becomes much keener and more confident.

15. Makes you avoid bad habits

Exercising regularly helps you get used to it hence making you avoid temptations and bad habits such as using tobacco, binge eating, excessive drinking and adultery.

16. Gives-off poisonous body waste and protecting body temperature

When you exercise, you will give off sweat profusely including poisonous waste and water, which is accompanied by excess temperature. So, exercising will help protect your temperature inside your body.

17. Improves skin health

It makes your skin clean and healthy. Likewise, bulging muscles make your skin stretchy and clear.

This is why those who do exercises usually seem to be healthy and who do not get old.

18. Makes you thirsty for water

When you exercise, your heart rate speeds up and your muscles work faster. These actions create a lot of heat in your body.

To cool yourself off, you begin to sweat, which causes water and salts from your body to seep out of your pores. Hence, you need to drink water in order to replace the lost fluids.

Drinking water helps replace water and salt wasted through sweating during an exercise hence making you continue to have a good blood circulation in your body.

19. Removes fatigue and pain

Fatigue causes the body’s pain feelings. So, exercising helps to discharge accumulation of Lactic Acid, which causes fatigue, pain, strain and inflammatory muscles.

Not only that, but also exercising reduces pain during the menstruation period in women.

20. Strengthens relationships

Exercises also increase muscle firmness including those muscles of the waist back that increases efficiency during sex by both partners hence strengthening relationships.

21. Treats virility in men

Exercising helps increase virility, controls excess obesity, helps smooth blood flow in the manhood muscles and dispels fear of making sex.

22. More firmness and strength to pregnant woman

Exercises help the pregnant women to prepare their waist muscles and hips to expand well so to enable her deliver safely.

Not only that, but also exercises enable the pregnant woman to have endurance and strength to push the baby during delivery.

23. Improves mental ability

It helps improve study ability, memory capacity and keenness. This is because exercises strengthen the consciousness system and that of the brain.

24. Reduces the risk of sudden death

Those who do exercises reduce the risk of succumbing to sudden deaths as the exercises also make you avoid having heart-related and blood vessel diseases.

25. Live a long life

Generally, all the above advantages and others contribute to making those who practise to have good health and ultimately living a long life because they are free from diseases.

Additional information from Daily Nation.


Hand, foot and mouth disease in babies

Monday May 13 2019

Legs covered with red spots, one of the signs

Legs covered with red spots, one of the signs of hand, foot, mouth disease. PHOTO | COURTESY 

By Tasneem Hassanali

Last Sunday, my daughter who turned 1 year and four months developed a mild fever around noon. She had just recovered from an ear infection and I began to think ‘maybe it was never over’.

By 3pm the fever rose and I had to administer paracetamol syrup for the fever to subside. By evening she began scratching the area around her ankles and elbows. Since she has eczema and scratching is quite normal for her, I ignored the sign.

Mild fever was the first sign. After the fever, she developed painful red blisters in her mouth, red or fluid filled blisters on arms and legs, loss of appetite, a sore throat and mouth, she was generally feeling tired and was very irritated. We all assumed it was chicken pox.

We took her to the hospital the same evening and upon examination, her paediatrician diagnosed her condition with what is called hand, foot and mouth disease (HFMD).

Her paediatrician told us that HFMD is a common viral illness that he has seen a lot of cases in Dar es Salaam lately and unfortunately there is no specific treatment. She was prescribed paracetamol syrup for fever and calamine lotion to soothe her blister-like bumps.

My daughter’s paediatrician warned me that HFMD is very contagious and the symptoms can get worse in the first three days before it begins to settle, which can take 7 to 10 days. HFMD is common in children under four years. It spreads easily – your baby can catch it if someone coughs or sneezes near her or from places such as playgroups or from sharing toys.

The bumps and spots gradually spread to the legs, bottom and groin. She was reluctant to eat or drink because the blisters in her mouth got very painful on the second day.

How I took care of her

Usually, baby with HFMD can become very grizzly and hard to settle, but there are things you can do to comfort her and this is what I did as advised by her paediatrician.

Since it hurt for her to swallow anything, I tried offering smaller but more frequent feeds of her usual milk.

I gave her soft, easy-to-eat meals, such as mashed potato or soup - nothing spicy or tart, as this could sting her mouth.

I gave her water or cold juice to sip every now and then for her to stay hydrated.

Infant paracetamol helped to relieve her pain and reduce her fever. Consult your physician on the dosage according to her age.

After a bath, I would pat her dry, as the affected areas of her skin were tender. I was also advised to trim her nails because scratching would pop the blister and could further infect other parts.

I also patted the affected areas with calamine lotion to soothe the blistered areas.

Warning signs

Health experts say that HFMD can’t be treated with antibiotics, because it’s a virus. It just needs to run its course, however miserable it is for your baby and you.

Sometimes, though, HFMD causes problems that do need a doctor’s advice. Take her to the doctor if you spot these signs:

• Drowsiness

• Tearless crying

• Drier nappies than usual

• Dark yellow wee

• Cold hands and feet

Keep an eye on your baby’s temperature too. Take her to the doctor if:

• Her fever doesn’t improve.

• She is under three months old and has a temperature of 38 degrees C or above.

• She is between three months and six months old and has a temperature of 39 degrees C or above.


According to’s health experts, frequent hand washing helps decrease the chance of spreading the infection. This is because the virus is found in poo, blisters and saliva, and from a runny nose.

Take special care to wash hands:

• After using the toilet

• When changing nappies (the virus can be found in poo for several weeks)

• When handling objects and toys which children hold or put in their mouths.

Keep your child at home if they are unwell or have blisters. It is important that your child does not go back to childcare or school until all the blisters have dried. Staying away from others who have the disease, cleaning/not sharing toys during the infection also helps prevent spread of the disease.


Here’s why too much TV can impair your child’s language

Monday May 13 2019

There are varied reasons for migraine

There are varied reasons for migraine headache.PHOTO|FILE 

By Dr Frank Njenga

The debate on the ideal length of time for children to spend in front of a TV screen continues to rage generating more heat than light.

At the end of the day the ultimate responsibility as to what is best for the child must rest with parents — no other authority can take over the role.

That said, there is evidence that time spent in front of a TV screen without much physical activity is not good for children.

Former US First Lady Michelle Obama led a campaign against obesity in children and in her autobiography, Becoming, she tells the story of her efforts to change children’s lifestyles.

These strategies included eating more vegetables and less junk.

To this end she dug up part of the White House lawn to grow vegetables! She also held strong views on physical activity for children, including limiting time they spent with electronic gadgets.

A few sobering facts might help shed more light.

Studies show that every two hours of watching TV leads to 23 per cent increased risk of obesity in women.

The same number of hours of watching TV increases the risk of diabetes by 14 per cent.

This means that excessive TV watching is harmful to your health. In a 2001 study published in the North American Paediatric Journal, the authors demonstrated the harm of watching TV in children.

In their conclusion, watching TV leads to obesity through a number of ways. The first and most obvious is the fact that children do not burn any calories as they sit fiddling with the remote control all day long.

By nature, children are meant to play. Whether one looks at humans, monkeys, lions or hyenas, the young of all these animals are in constant play.

Television is the unnatural intruder since it slows down physical activity in children.

It is impossible to see obese antelopes or lions at the Maasai Mara because they play a lot.

In captivity, however, many animals become obese, just like children who do not play and instead rely too much on electronic gadgets.

Beyond reduced activity, children eat more (junk) food while inactive. This happens for two reasons.

The first is the reality that the fridge is near and any left overs are easy to get to.

A child playing outside the home has less access to snacks than one who is inside the house. Any visual cues of food near them is a sign to eat, be it a biscuit or cake, left lying around. Sadly, the more the child eats the more he has to eat. Manufacturers of junk food and drinks are aware of this and insert food and drink adverts on the screen to “remind” children to eat and drink.

The third and less obvious reason is that as a child watches TV or something on the phone he is less conscious of what is going on in the body.

Some children regularly wet themselves as they watch cartoons. Engrossed on the screen, the child is unaware of the fullness of the bladder and only becomes aware of it when it is too late to rush to the toilet.

In a similar way, a child eating while watching TV is unaware of the sensation of being full. He eats in a mechanical way and keeps on eating even as the body tells him to stop.

What I have said about childhood obesity above will apply to speech development in your five-year-old.

Speech develops in a social context and the more a child interacts with adults and other children the more vocabulary they learn. In this regard, I suggest that you take your neighbour seriously.

The article was first published in The Business Daily.

The author is a mental health consultant who has authored several scientific papers and books.


It was never too late for Elisha to get vaccinated

Monday May 6 2019


By John Namkwahe


Let’s not ignore signs of depression in men

Monday May 6 2019

A stressed man in thoughts. PHOTO | NMG

A stressed man in thoughts. PHOTO | NMG 



Why all children need HPV vaccine to prevent cancer

Monday May 6 2019


By Dr Chris Peterson


Why I quit being a sex worker

Monday April 22 2019


By John Namkwahe @johnteck3


When hormonal contraceptives wreak havoc

Monday April 22 2019


By Dr Nelly Bosire


Glaucoma: The sneak thief of your eyesight

Monday April 22 2019


By Jamilah Khaji


Here’s why your body needs the good sugar

Monday April 22 2019


By Beatrice Nakibuuka


Seriously ill patients need affordable and quality care

Monday April 22 2019




Tapping into the power of nurses and midwives

Monday April 15 2019


By John Namkwahe @johnteck3

Victor Mwibese, 22, a third-year student at St Magdalene School of Nursing and Midwifery in Kagera narrates to Your Health his passion and commitment to work in rural health facilities and assist in reducing maternal deaths in women and children.

He believes that modern health methodologies that he will acquire after completing his nursing course will enable him to handle complex complications related to delivery more precisely.

Mwibese’s major concern is about a critical shortage of skilled maternal health services providers which he himself perceives it as a driving factor attributing to maternal deaths burden in the Lake Zone and other parts of the country.

“Ignorance and lack of education on reproductive health among some nurses and midwives particularly in rural areas, are key factors that attribute to maternal deaths,” Mwibese tells Your Health during an interview.

As a young and inexperienced health professional, Mwibese uses his holidays to work at a health facility in his village in assisting the maternal health services providers to handle deliveries and complex complications that endanger the life of both mother and unborn child.

“The problem is that we (young nurses) sometimes face difficulties to work with senior nurses in the facilities because they don’t trust our capacities to handle maternal matters just because we are still learning,” says Mwibese.

Backing up Mwibese’s arguments, Grace Mliambate, who is also a third-year student at the school, says the existing shortage of skilled health professionals in rural areas is attributable to a shortage of modern learning equipment in the country, as a consequence, the schools produce incompetent graduates.

“Availability of modern learning equipment is essential in facilitating the acquisition of modern health methodologies among students,” says Mliambate.

Health workforce issues particularly the substantial shortage of maternal health service providers with nursing and midwifery skills jeopardize the government’s efforts to scale up coverage for maternal, new-born and child health. Based on a recent visit to Missenyi District, in Kagera, Your Health interviewed the District Medical Officer (DMO) Dr Hamis Abdallah about the shortage of health professionals.

The DMO confirmed that the district is hit by a critical shortage of health professionals including maternal health services providers.

“Health professionals’ unwillingness to work in unreached areas like islands is another factor attributing to under-staffing in the lake zone particularly in rural areas,” says Dr Abdallah.

According to him, there are 32 islands with a population of over 300,000 people in Missenyi District.

“During the 2017/18, only 12 healthcare providers were distributed to the district. The demand for health services is still high in the district, therefore I call upon the government to distribute more professionals,” says Dr Abdallah.

The existing shortage of health professionals in the district, particularly in the rural, is also contributed by lack of graduates with good competencies to cover the gap, according to the DMO.

Due to the shortage, the Lake Zone that comprises Mwanza, Mara, Kagera, Simiyu, Geita and Shinyanga regions continue to be the country’s part with the greatest burden of maternal ill-health.

According to recent statistics availed by Ministry of Health, Community Development, Gender, Elderly and Children, a total of 1,744 maternal deaths occurred in Tanzania Mainland in 2018.

At least 262 out of the deaths occurred in the Lake Zone, whereby Mwanza region alone recorded 151, becoming the region with the highest number of maternal deaths.

World Health Organisation (WHO) data indicates that the main direct causes of maternal death in Tanzania are haemorrhages, infections, unsafe abortions, hypertensive disorders and obstructed labours.

Henceforth, the availability of skilled health providers particularly midwives, nurses and doctors is critical in assuring high-quality antenatal, delivery, emergency obstetric and post-natal services in the region.

Indeed, the Sustainable Development Goals (SDGs) for maternal health is unlikely to be achieved without attention to the recruitment and retention of health professionals.

In this context, St. Magdalene School of Nursing and Midwifery in Muleba District, Kagera region has embarked on modern methodologies to recruit more young and competent nurses and midwives to deal effectively with the maternal burden in the Zone.

“The causes of maternal mortality and morbidity are well known, and mainly result from the inability of a health system to deal effectively with complications, especially during or shortly after childbirth,” says Renata Scarion, the St. Magdalene School’s Principal.

According to her, the school offers nursing and midwifery education in Diploma and Certificate levels. Currently, the school has registered 142 students pursuing nursing and midwifery education.

The school is among 10 private medical institutions in the region that benefited from the $32 million (equal to Sh70 billion) project dubbed ‘Maternal and Child Survival Programme (MCSP)’ led by Jhpiego in partnership with the health ministry and the Regional Administration and Local Government, funded by the USAID.

The organisation under the project donated lab skills equipment such as Mankins to facilitate learning in medical schools.

The schools also benefited through various training programmes aimed at building capacities of teachers to ensure they effectively equip the students with modern health methodologies related to reproductive health.

Referring to the positive impacts of the project, Ms Scarion reveals that the school performance in providing quality education pertaining to nurse and midwifery has increased from 48-94 per cent.

However, she further reveals that the school is hit by a critical shortage of funding.

“Majority of boys and girls in the region are keen on joining the school, but they are unable to afford the fees. I, therefore, call upon the donors and private institutions to offer scholarships to them,” says Ms Scarion.

Speaking to Your Health, Mr John George, the MCSP project director advised the school management to market itself through social media platforms, radio and television in order to increase enrollment of students.

Meanwhile, Mr George further noted that Jhpiego in collaboration with the government of Canada under ‘More and Better Midwives project’ was determined to continue offering scholarships to young Tanzanians pursing health courses.

Indirect effects of shortages in maternal health care

According to, Ms Placidia Muganguzi, a Reproductive and Child Health (RCH) in charge at the St. Joseph Hospital-Kagondo, in Kagera, an increasing workload within the health facilities due to a shortage of maternal health services providers can affect both the quality and safety of maternal care.

“This is especially relevant for rapidly evolving programmes in reproductive health, HIV/AIDS and tuberculosis, where strategies must be reinvented and re-taught, due to the loss of key personnel and the resulting loss of continuity,” says Ms Muganguzi.

Adding, “Staff may also need to work unpaid overtime to complete work to the level they are satisfied with.”

She further called for health sector reforms and macro-economic development policies to focus on curbing maternal deaths in the country.


Lifestyle diseases can affect children too

Monday April 15 2019


By Your Health Reporter

When she was two, Maxine Kateregga, now 15 fell ill and started vomiting, feeling constantly thirsty and sleepy. “I also frequently asked my sister for sugary foods and drinks. Being sick and the last born, I guess she gave them to me out of sympathy,” she recollects. Little did her sister know that Kateregga had diabetes.

On her first day in Primary Seven, while waiting for the bus at home, she fainted. She was taken to hospital and after several tests, the doctor said she had ketones and her sugar levels were extremely high.

“I was in that state for a week and was disoriented when I finally woke up. I could not understand why I was in hospital,” Kateregga says adding that this is when the doctors told the family that she had diabetes.

Her life has changed drastically since then, “I never had to worry about my blood sugar but now I take medicine twice daily to control it. I previously ate whatever I wanted but was advised to stop taking sweet things such as candy, chocolate as well as soda,” she says. Katerega was also advised to lose weight lest her condition worsens.

“Although I was not a workout enthusiast, I now make time to either walk or exercise. I have also started playing lawn tennis and I have lost weight. I also eat smaller food portions thrice a day with lots of fruits and vegetables,” she says.

Kateregga adds that with time, she was told that she has Type 2 diabetes and all the changes, though difficult to adopt have helped her manage the disease.

She is thankful for her family’s support because she says she could have cheated or given up but they have been there to the point of adopting healthier lifestyles too.

Although, for the most part, diseases in childhood are similar to those in adults, Dr Sabrina Bakeera-Kitaka, a paediatric and adolescent health specialist, says there are several differences. For example, certain health issues such as precocious puberty, acute nephritis (inflammation of the kidney) are unique and common among children yet infrequent in adults.

Dr Kitaka also points out that some ailments such as gout, and hypertension (high blood pressure of unknown cause) are common in adults and not in children. That said, infectious disorders remain the leading cause of death. Some of these include measles, chicken pox and mumps.

Dr Boniface Ssegujja, a paediatrician at Naalya Children’s Clinic, adds that the prevalence of most of these has been lowered by immunisation. However, society is now grappling with diseases that were predominantly found in adults but now affect children.

Type 2 diabetes

This is when one’s body cannot control blood sugar because either the body is not producing enough insulin or its sensitivity to insulin is low hence being insulin resistant.

Typically, children suffer from Type 1 diabetes because their bodies are not producing insulin.

On the other hand, Type 2 diabetes is where one’s body cannot control blood sugar because either the body is not producing enough insulin or is insulin resistant and was common among adults.

However, lately, several children are suffering from this type of diabetes. Dr Ssegujja says one of the leading causes of Type 2 diabetes is obesity, “Many are severely overweight and one in four obese children will have Type 2 diabetes. This is because obesity increases the chances of a child getting Type 2 diabetes four fold,” he says.

He adds that some of the factors that lead to obesity in children is poor diet where children are fed on high sugar foods such as ice-cream and pastries which are loaded with calories.

“While these calories are meant to give them energy, in excess, they are stored by the body leading to insulin resistance,” Dr Ssegujja explains.

Most children also live sedentary lifestyles where they are drawn to video games and watching TV. However, according the World health Organisation (WHO), children and young people (5-17 years) must engage in physical activity such as sports, chores, recreation, physical education, or planned exercise, in the context of family, school, and community activities.

In order to improve cardiorespiratory and muscular fitness, bone health, and cardiovascular and metabolic health biomarkers, WHO recommends that children accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily.

The organisation suggests that most of the daily physical activity should be aerobic while vigorous-intensity activities should be incorporated to strengthen muscle and bone, at least three times per week.


GUEST COLUMNIST: Think twice before popping that medicine

Monday April 15 2019

Dr Chris Peterson

Dr Chris Peterson 

By Dr Chris Peterson

Suppose you wake up one morning feeling tired, with a headache and mild fever. Probably because of your busy schedules at work, you fail to report to the doctor for consultation and you decide to go for a self-prescription at a nearby pharmacy in an attempt to find relief. The medicines show some improvements on that particular day.

Unfortunately, the scenario seems to be the same when you wake up the next morning and you decide to go again to the same pharmacy to get your pain relievers.

It is true that this has been a habit of many of us but have we ever asked ourselves just how inappropriate it may be to use multiple over-the-counter drugs without being medically consulted? What if by doing that we worsen the disease instead of treating it? Or are we really aware, of such a thing called drug dependency?

One of the most common questions that people bombard me with in an effort to solve their medical concerns is; What medication should they take instead of explaining their problem, signs and symptoms.

I want to remind everyone that taking certain tablets cannot always be a wise decision for your health, especially if your medical condition is not an emergency.

Instead, take some time to understand what exactly your medical condition is, understand your body well, listen to symptoms, try at your knowledge to figure out what caused it, and before you take that tablet, seek medical advice from the hospital.

Suppose you thought of taking some tablets for your headache relief, while the doctor finds out, it only requires you to drink enough of water and have some time to rest?

John’s case

Few days ago, I came across John (not his real name), my patient. When he entered the consultation room, he complained about long history of general body fatigue, loss of appetite, lower back pain and fore headache on and off for almost two weeks that led to fevers.

According to John, he was convinced that it was malaria that was behind his nightmare especially when he found out even several rounds of painkillers were not of any help. “Please doctor, of all the medications you are going to prescribe for me, please don’t forget antimalarial and those for typhoid; I’m sure it might be malaria or typhoid that is bothering me” he insisted.

During our conversation, I came to learn that John had some emotional issues, after he revealed to me about some social challenges that he encountered about a month ago, leaving him depressed, and extremely stressed, and I was sure that was enough to cause his complaints.

But John didn’t pay attention to his psychological issues, he only paid attention to what appeared the side effects of his psychological issues.

Just to remind you my dear reader, if someone is stressed or emotionally unstable, he/she is much more likely to experience a number of complications like, loss of appetite, extreme fatigue, headache, especially fore headache, or even fever just like what John went through.

In this particular case, I was sure that, John, had neither malaria nor typhoid as he claimed. In fact he had no indication for those conditions, even though he kept insisting on treating them. I ordered stress test instead; a medical test that measures the heart’s ability to respond to external stress, to make sure that John’s stress hasn’t affected his heart, causing him any cardiac issue.

Finally, I offered him a psychotherapy and few tablets to control the symptoms of depression, and counselled him on how he can find emotional stability again and reassured him that he is going to be okay with the counselling.

Few days later, John turned up again and this time he was grateful that the counselling he was given was helpful to him since he was able to deal/ treat the psychological issues. John confessed that he was wrong to dwell in his self-diagnosis.

The author is a medical doctor based at Sanitas Hospital in Dar es Salaam.


Pregnancy illnesses you should not ignore

Monday April 15 2019


By Your Health Reporter

During the third trimester, an expectant mother is anxious but also happy that they are almost giving birth. The discomfort as you waddle around on your swollen feet, worries about how the labour will go and how healthy your baby is, may make you wish the baby would just pop out.

At this time, many of the worst risks and symptoms you and your baby experience are already over and the long awaited due date is closing in.

It was the same for Allen Nanyanzi, a mother of three. Her first pregnancy was not as bad in the first trimester, she had spotting but it cleared in two days.

Many people had told her about morning sickness but she did not experience it. “Everything apart from the two-day spotting in the second month was normal. I went for my first, second and third antenatal visit and everything was normal,” she says.


In the seventh month, however, Nanyanzi’s feet started swelling. She immediately went to hospital and the doctor told her that her blood pressure had risen. She was given medication to lower the pressure and was put on bed rest. After a week, she was discharged because the pressure was normal.

“After three weeks, the swelling was on again. I heeded the doctor’s advice and went to hospital immediately. I was diagnosed with preeclampsia and was told that the baby had to be removed as soon as my blood pressure was back to normal,” she recalls.

She was given medication but her blood pressure failed to normalise. “I saw doctors run up and down as they tried all means but things failed. I started getting nervous, started sweating because I feared I was going to lose my first born. I asked the doctors to do whatever they could to save it,” she says. By the time the pressure normalised, the baby had stopped moving. “The doctors said it had died. I had induced labour and was told to push normally. This was the worst moment in my life. The thought that I was going through pain for a dead baby made me cry throughout the delivery process. Other women had their babies cry after delivery but mine was dead,” she recalls.

For the subsequent births, Nanyanzi has always gone to hospital for review as soon as she clocks seven months and takes medication to keep her pressure normal.

Like Nanyanzi, many women notice some symptoms during their third trimester and ignore them yet some are fatal for both mother and baby.

Blurred vision, dizziness, headaches

Headaches that often make you feel dizzy and your vision blurry could be symptoms of preeclampsia. They may be accompanied by swollen hands, stomach pain (especially on the right side), and high blood pressure.

Dr Charles Kiggundu, an obstetrician/gynaecologist at Kawempe general hospital, says if it is not treated, a mother with preeclampsia will develop eclampsia, which causes seizures, kidney failure, and the death of mother and baby.

“You will need a variety of medications to bring down your blood pressure, prevent seizures, and improve your liver and kidney function,” Dr Kiggundu says.

After the blood pressure returns to normal, the baby must be delivered as soon as possible. You may need to undergo induced labour or a C-section, depending on how far you are into your third trimester.

Avoiding complications

Even if you do not have an existing health problem, many doctors recommend a preconception appointment with your health-care provider to ensure you are as healthy as you can be before you become pregnant. At this appointment your doctor may recommend steps you can take to reduce the risk of certain problems.

• Getting at least 400 micrograms of folic acid daily beginning before and continuing through pregnancy.

• Getting proper immunisations.

• Eating a healthy diet and maintaining proper weight.

• Getting regular physical activity, unless advised otherwise by your doctor.

• Avoiding cigarettes, alcohol, and drugs (except for medications approved by your doctor).

See your doctor immediately if you experience the following symptoms:

• Fainting

• Fatigue

• Unusual discharge

• Bleeding

• Baby stops moving

•Water breaking


Swollen feet? Here’s when to worry about it

Monday April 8 2019

Dr. Christopher Peterson

Dr. Christopher Peterson 

Swollen ankles and swollen feet are common and usually not cause for concern, particularly if you have been standing or walking a lot.

Sometimes you end up with swollen feet due to host of external factors such as injuries or nature of your work.

Our feet are probably one of the hardest working parts of our bodies, supporting our body weight and letting us, walk, run, working cooperatively as a team, which adds up a lot of wear and tear.

That is why no wonder a number of patients come to me complaining of swollen feet.

Like I said, injuries, body inactivity, tiredness, or sometimes the type of shoes which are worn can cause feet to swell, and we always offer counselling to patients with swollen feet when they seem to have some of these causes.

Is swollen feet something to worry?

A lot of patients ask me this question. In many cases, swollen feet can be worrisome, but majority of people always do not take it as serious as it may be, which eventually put them in major health concerns.

In this article therefore, I want to highlight just how swollen feet can be a warning from major hidden health concerns, especially when there is so much swelling that it leaves an indentation if you press your finger into it.

1. Heart failure

Swollen feet can be a sign of the heart failure. You may not believe it, but swollen feet and heart failure are highly connected. Heart failure doesn’t mean your heart stops working suddenly, just that, your heart can’t pump enough blood.

This means, blood backs up in the vein, leading to form fluid. This happens especially when the right side of the heart fails to function, which causes the body to retain salt and water resulting in swollen feet.

I therefore, urge you my readers to pay close attention to symptoms that may dim heart failure.

Apart from swollen feet, associated signs are: shortness of breath particularly when exercising or lying down, rapid heartbeat, weakness, fatigue, rapid weight gain from fluid and loss of appetite.

2. Kidney failure

Swollen feet can also be a sign of kidney failure. Your kidneys are responsible for balancing fluid that is no longer needed out of the system.

When one or both don’t function properly, you might end up with swollen feet, because the unwanted fluids which were to be secreted out by the kidney have looked for somewhere else to settle.

With kidney problems, your body has trouble getting rid of fluids then, that swelling is more marked, and not just in the feet, some people with kidneys issues have swelling on other parts of the body too like their hand and face.

Apart from these, swollen feet can be a sign of other many medical issues as well, liver diseases, unbalanced cholesterol, infections of the bones, lymphedema, and foot injuries just to mention few. Finally, my take-home message is, don’t always make your own diagnosis.

3. Pregnancy complications

Some swelling of the ankles and feet is normal during pregnancy. Sudden or excessive swelling, however, may be a sign of preeclampsia, a serious condition in which high blood pressure and protein in the urine develop after the 20th week of pregnancy.

If you experience severe swelling or swelling accompanied by other symptoms such as abdominal pain, headaches, infrequent urination, nausea and vomiting, or vision changes, call your doctor immediately. With so many potential reasons for swelling, it is important to let your doctor to drill down to the cause, prescribe the treatment you need, and help you get back on your feet, as soon as possible.

The author is the medical doctor at Sanitas hospital.


Taking time to spot signs of colon cancer

Monday April 8 2019


By Jamilah Khaji

When 39-year-old Salum Awadhi spotted an artwork on colon cancer signs, he got really worried. He says, “Seven out of the ten signs that were on the artwork was happening to me. I was going through all that.”

Salum decided to go for a check-up the very next day so as to rule out anything worrisome that was already clouding his thoughts.

“Apart from this I have been suffering with other stomach diseases of which I have undergone several surgeries in India. I have to make sure I am okay. It is better to get to know the problem as early as possible before it is too late,” says Salum who was one among the many people who turned up at Ocean Road Cancer Institute (ORCI) in Dar es Salaam during a free colon cancer (saratani ya utumbo mpana) screening last month.

“The other reason why I have come for a check-up is because cancer is part of my family’s history. My grandfather, uncle and aunt died of cancer. That is why I thought it is wise for me to get it checked,” he adds.

It is Salum’s first time checking for colon cancer but has always believed to get his health status checked in case of any warning signs.

What signs to watch out for

A change in your bowel movement/habits is something to take note of, says Dr Maguha Stephano, ORCI Manager for Cancer Screening and Public Education.

The important signs and symptoms of colon cancer include:

• A change in your bowel habits, including diarrhoea or constipation or a change in the consistency of your stool, that lasts longer than four weeks

• Rectal bleeding or blood in your stool

• Persistent abdominal discomfort, such as cramps, gas or pain

• A feeling that your bowel doesn’t empty completely

• Weakness or fatigue

• Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the cancer’s size and location in your large intestine.

World Health Organisation’s 2018 cancer fact sheet reveals that cancer is a leading cause of death worldwide, accounting for an estimated 9.6 million deaths in 2018. Colon cancer is the third most common cancer in the world affecting more than 1.8 million people and causing 862,000 deaths a year.

Is nyama choma culture to blame?

Dr Stephano pointed that the biggest problem with Tanzanians is unhealthy eating and lifestyle. “Excessive eating of red meat, with a lot of oil has proven to be dangerous for our stomach,” he says.

Meat digests very slowly, this causes constipation and when you have constipation, it means the wastes are not removed from the stomach which is bad for the body. Also meat which is cooked by smoke (barbeque and nyama choma) is more dangerous because the smoke contains hydrocarbon, which in a long run can lead to cancer. Also preserved meat like sausages and bacon is bad because of the chemicals that are used.

Other factors that may increase your risk of colon cancer include:

• Older age. The great majority of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

• Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer.

• Family history of colon cancer. You’re more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater.

• A sedentary lifestyle. If you’re inactive, you’re more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.

• Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.

• Smoking. People who smoke may have an increased risk of colon cancer.

• Alcohol. Heavy use of alcohol increases your risk of colon cancer.

Prevention is better than cure

Dr Stephano advises people to start making lifestyle and dietary changes to reduce the risk of colon cancer.

He says, “Eat a balanced diet that incldues lots of vegetables and fruits. This helps the body produce more immunity to fight and prevent against diseases. Limit oily and smoked foods too.”

Eating high fibre foods such as carrots, banana, broccoli, apples, beetroots and sweet potatoes helps in digestion.

Exercise at least 30 minutes a day. People with an average risk of colon cancer can consider screening beginning at age 50.

But people with an increased risk, such as those with a family history of colon cancer, should consider screening sooner.